Cris Renata Grou Volpe

Acolhimento na atenção primária à saúde na ótica de enfermeiros

Objective To understand how the welcoming process occurs in the basic health units from the viewpoint of nurses. Methods An exploratory study with a qualitative approach that used semi-structured interviews, and adopted the content analysis technique proposed by Bardin for data analysis. Results Among the ten interviewed, nine were female. Analysis of the statements led to the emergence of access and the work process as empirical categories. Conclusion Welcoming is performed in the Basic Health Units of a Regional Federal District, but not in a structured manner, nor is it grounded in the recommendations of the Ministry of Health.

Oxybutynin and tolterodine for treatment of neurogenic detrusor overactivity: a pharmacoeconomic evaluation in the Brazilian context

A terapia antimuscarinica e vista como primeira escolha para o tratamento da hiperatividade detrusora de origem neurologica (HDON). No entanto, a maioria dos antimuscarinicos existentes e amplamente estudada em pacientes portadores de hiperatividade detrusora idiopatica. Assim, existe escassez de pesquisas que avaliam esses farmacos na problematica da HDON, principalmente em termos de estudos de custo-efetividade. Diante isso, um estudo farmacoeconomico foi realizado (baseado no indice de preco maximo ao consumidor) para comparar os custos e a efetividade da oxibutinina e da tolterodina, em duas diferentes formulacoes, capsulas de liberacao imediata (LI) e controlada (LC), para o tratamento da HDON. Uma revisao sistematica da literatura foi conduzida para obtencao de dados urodinâmicos e clinicos relevantes (baseado em opiniao de especialistas), quanto aos efeitos desses farmacos em pacientes com disturbios urologicos de origem neurologica. Apos essa etapa, um estudo farmacoeconomico foi conduzido e os custos envolvidos foram calculados sobre cada percentual de efetividade obtido, num horizonte temporal de 1 mes e 1 ano. A melhor razao de custo-efetividade (RCE) quanto aos parâmetros urodinâmicos foi obtida com uso de oxibutinina LI. Quantos aos parâmetros clinicos, oxibutinina LI e LC tiveram as melhores RCE. Baseando-se nos principais parâmetros urologicos analisados, oxibutinina LI foi considerada o antimuscarinico mais custo-efetivo.

Quality of life and time since diagnosis of Diabetes Mellitus among the elderly

Objectives: To evaluate the quality of life of the elderly with Diabetes Mellitus and to relate the time since diagnosis of diabetes with the quality of life of elderly persons receiving care at a basic health unit. Method: A cross-sectional quantitative study carried out in a Basic Health Unit with 196 elderly persons. For data collection, three instruments were used: one structured (sociodemographic and clinical variables) and the Whoqol-bref and Whoqol-old, with scores ranging from 0 to 100. Descriptive statistical analysis, Student’s T-test and Pearson’s correlation were performed. Results: Of the 196 diabetic patients, the majority were male (54.6%) with a mean age of 67.5 (±6.5) years. The mean time since diagnosis of Diabetes Mellitus was 9.1 years. The domains of the Whoqol-bref with the highest scores, indicating better quality of life, were Social Relations and Psychological, while a worse quality of life was observed in Environment. The facets of the Whoqol-old with the best scores were: Intimacy and Past, Present and Future Activities, and the worst was Death and Dying. The domains associated with one another were Physical and Psychological, Physical and Social Relations, and Psychological and Environmental. The associated aspects were Past, Present and Future Activities and Social Participation. Elderly persons with more than ten years of Diabetes Mellitus had worse quality of life scores in Physical (p=0.001), Social relations (p=0.002), and in the Autonomy (p=0.0012), Social Participation (p=0.041) and Death and Dying (p=0.001) facets. Conclusion: The time of diagnosis of Diabetes Mellitus was negatively associated with the quality of life of the elderly, with worse scores in most domains and facets of the Whoqol.

Lower quality of life, lower limb pain with neuropathic characteristics, female sex, and ineffective metabolic control are predictors of depressive symptoms in patients with type 2 diabetes mellitus treated in primary care

The primary objective of this study was to identify if lower limb pain with neuropathic characteristics is predictive of depressive symptoms in patients with type 2 diabetes mellitus (T2DM) treated in primary care in Brazil. It was investigated if diabetic and non-diabetic related variables could influence depressive symptoms. A quantitative and cross-sectional study was carried out in two Basic Health Units with users of the Brazilian Public Healthcare System, who were evaluated for depressive symptoms (BDI), quality of life (QoL, SF6D), pain intensity, neuropathy (loss of plantar sensitivity—LOPPS), body composition (DEXA), biochemical tests, sociodemographic variables, and comorbidities. The patients were stratified into four groups: N+P+, N+P−, N−P+, and N−P− (N = neuropathy and P = pain). One hundred twenty-one diabetics were selected by random sampling between August 2016 and June 2017. Neuropathy affected 53.8% of these individuals, and 59.5% reported intense pain. Overall depressive symptoms scores showed a positive correlation with pain intensity and a negative correlation with QoL. Depressive symptoms were reported by 66.9% of the sample, mostly female, with better levels of cholesterol, HDL and LDL; comorbidities; worse QoL; greater intensity of pain; impaired sleep; and painful neuropathy (N+P+). The predictive factors for depressive symptoms were lower QoL, pain with neuropathic characteristics, female sex, obesity, and ineffective glycemic control. These data may contribute to the understanding of the complexity of patients with T2DM who are treated in primary care and to public policies planning of care directed at the needs of this population.

Mapping the Medication System: Weaknesses and Risk Management

Secure systems aimed at preventing medication error are the essential. Our objective was to describe and map the medication system of a large hospital in Brasilia, DF, Brazil and propose risk management strategies for their principal weaknesses. For this cross-sectional, exploratory, and descriptive study, the data was collected with the support of two nurses trained by the researcher. Direct observations and semi-structured interviews of professionals involved in the medication system covered the processes: prescription, dispensing, preparation, and administration of medications. The data collection period was from May 8 to 22, 2012. Eight nursing technicians from this study site, who are responsible for the preparation and administration of medications, participated in the study. We identified 34 activities, undertaken by different professionals, which show the complexity and greater possibility of error. The weaknesses identified include interruptions, displacement, environmental problems, human resources, lack of patient identification, infrastructure, technical problems during preparation and administration, as well as deficiencies in compliance with rules and security protocols. It was concluded that the more the process is computerized the less weaknesses are present. Therefore, implementation of risk management strategies and the use of technologies are needed to detect and reduce risks to ensure the quality of the executed processes.

Hability of aged to perform activities of daily living: a descriptive study

Problem :The decrease or loss of functional capacity is a process that can be aggravated by diseases. Objective : to evaluate the capacity of the aged to perform activities of daily living and instrumental activities of daily living. Method : in a quantitative descriptive performed, in day hospital of old in Anapolis-GO. The 30 aged participated and answered 3 instruments: questionnaire, Lawton Scale and Functional Independence Measure. Results : In the Activities of Daily Living had been observed more dependency for use of ladders, memory, locomotion, control of urine, problem solving, social interaction and get dress below the waist. For the Instrumental Activities of Daily Living had partial dependency housekeeping and shopping, and full-pending use the phone and take care of finances. Conclusion : Before the results it is possible to infer that strategies that seek to the improvement of the ageds functionality can favor the aging autonomous, independent and free from offences to the health.